Medicare Part B Drug Associate Job at Medasource (Boston)

Medicare Part B Drug Associate

Medasource

Location:
United States , Boston

Category:
-

Contract Type:
Not provided

Salary:

20.00 - 30.00 USD / Hour

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Job Description:

Our client, a leading healthcare provider, is seeking a Medicare Part B Drug Associate for a fully remote, contract-to-hire position. In this role, you will be responsible for managing, reviewing, correcting, and resubmitting Medicare Part B drug claims across both pharmacy benefit management (PBM) and medical drug billing channels. You will ensure accurate reimbursement and compliance with CMS regulations for both pharmacy-dispensed drugs (such as DME-related medications, immunosuppressants, and inhalation drugs) and provider-administered drugs (including infusions, injections, and oncology drugs) billed under the medical benefit. The ideal candidate brings expertise in both Part B drug billing pathways, strong analytical skills, and a proactive approach to reducing avoidable denials. You will collaborate closely with pharmacy managers, clinical staff, coders, and billing teams to resolve claim issues, maintain compliance, and support process improvements. This position requires working EST hours and is available for an immediate start with the potential for permanent employment.

Job Responsibility:

Review Medicare Part B drug claims for accuracy, completeness, and compliance prior to submission across both PBM (pharmacy-billed) and medical drug (provider-billed) channels
Analyze Medicare remittance advice (RAs) to identify denial reasons specific to Part B drug billing—including NDC-to-HCPCS mismatches, AWP pricing issues, and documentation gaps—and determine appropriate corrective actions
Communicate findings and corrective actions to pharmacy managers, clinical staff, and billing teams
Rebill corrected claims through the appropriate Medicare channels (DDE, clearinghouse, PBM platform, or EMR) for both pharmacy-dispensed and provider-administered drugs
Research and resolve coding, modifier, NDC, HCPCS, and documentation issues affecting claim acceptance for both PBM and medical drug billing pathways
Coordinate with clinical teams, pharmacists, coders, and billing staff to obtain missing or corrected information, including drug administration records, orders, and medical necessity documentation
Track and follow up on outstanding Medicare Part B drug claims across both billing channels to ensure timely reimbursement
Maintain detailed documentation of rebill activity, denial trends, and resolution steps for PBM and medical drug claims
Monitor CMS updates, LCD/NCD changes, drug pricing files (ASP, AWP), and Medicare Part B drug billing guidelines to ensure ongoing compliance across both channels
Differentiate and apply appropriate billing rules for drugs dispensed by pharmacy under Part B vs. drugs administered by a provider under the medical benefit
Assist with month-end reporting, audit preparation, and process improvement initiatives for both PBM and medical drug revenue cycles

Requirements:

3-4+ years of experience in Medicare Part B billing, including both PBM (pharmacy-dispensed) and medical drug (provider-administered) billing or revenue cycle operations
Strong understanding of Medicare Part B drug regulations, claim formats, and common denial codes for both billing channels
Proficiency with billing software, clearinghouses, PBM platforms, and Medicare DDE (Direct Data Entry)
Working knowledge of HCPCS/CPT codes, NDC codes, ICD-10, and appropriate modifier usage for Part B drugs (e.g., JW, JZ, GY, KX modifiers)
Understanding of Part B drug pricing methodologies, including Average Sales Price (ASP), Average Wholesale Price (AWP), and drug-specific reimbursement rules
Ability to differentiate and apply billing rules for pharmacy-dispensed vs. provider-administered Part B drugs
Ability to interpret EOBs/ERAs and identify root causes of denials for drug claims (e.g., drug not covered, no prior authorization, medical necessity)
Excellent attention to detail, problem-solving skills, and follow-through
Strong written and verbal communication skills

Nice to have:

Experience with Epic, Inovalon, or specialty pharmacy billing platforms
Background in oncology, infusion, or specialty drug billing under Part B medical benefit
Familiarity with Medicare Advantage plans and secondary billing workflows for Part B drugs
Experience with PBM-specific Part B drug billing for DME-related medications, immunosuppressants, or inhalation drugs
Knowledge of prior authorization and coverage determination processes for Part B drugs
Certification such as CPC, CPB, CPMA, or equivalent
Specialty pharmacy or oncology billing certification

What we offer:

Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage
401k plan that includes a company match and is fully vested after you become eligible
Paid time off, sick time, and paid company holidays
Employee Assistance Program (EAP) that provides services like virtual counseling, financial services, legal services, life coaching

Additional Information:

Job Posted:
March 20, 2026

Employment Type:

Fulltime

Work Type:

Remote work

Medasource - All Job Offers

Job Link Share:

Medicare Part B Drug Associate

Medasource

Location:
United States , Boston

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 20, 2026

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Medicare Part B Drug Associate

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Location:United States , Boston

Category:-

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:March 20, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

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